What do we know about care home managers? Findings of a scoping review

Orellana, Katharine; Manthorpe, Jill; Moriarty, Jo

doi:10.1111/hsc.12313

Cited by 34 publications

(45 citation statements)

References 23 publications

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“…Registered managers roles are complex, often experienced as ambiguous and include significant administrative demands (e.g., Orellana et al, 2017;Beadle-Brown et al, 2006;Bradshaw et al, 2018;Deveau & McGill, 2016b;Clement & Bigby 2012). Depending upon organisational expectations of RM, which may prioritise administrative work (Mansell & Elliott, 2001) this ambiguity and administrative load is likely to clash with providing PL.…”

Section: Discussionmentioning

confidence: 99%

Staff experiences working in community‐based services for people with learning disabilities who show behaviour described as challenging: The role of management support

Deveau

McGill

2019

Brit J Learn Disabil

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Accessible summary We looked at staff working with people with a learning disability and challenging behaviour. We tried to find out if managers' help their staff to work better. We looked at how often staff saw their manager and if their manager tried to help their staff to work better or spent more time doing office work. We found out that when managers helped staff to work better, staff feel better about their work. Even when staff did not see their manager very often, other staff were helping them to do their work better. Organisations need to decide who will help staff to work better, and this will also help staff to feel better about their work. Abstract IntroductionResearch has shown a positive relationship between practice leadership (frontline management focused upon supporting staff to work better) and better staff experiences of working with people with learning disabilities who may show challenging behaviours. However, little is known regarding the impact of frequency and accessibility of frontline managerial support upon staff experiences, or upon the provision of practice leadership. Current policy and practice in England may lead to frontline managers being responsible for more fragmented services, thus influencing the accessibility of managerial support and practice leadership for staff. The current study investigated the impact on staff experiences of frequency of contact with service manager and of practice leadership. MethodsA single point in time survey of 144 staff measured: characteristics of service users, frequency of contact with manager, practice leadership and staff experiences, for example burnout, teamwork and job satisfaction. ResultsPractice leadership was positively associated with more frequent contact with the manager. Better staff experiences were associated with more frequent contact with the manager and practice leadership and negatively with challenging behaviours. ConclusionThe associations between practice leadership, manager contact and better staff experiences suggest further research, and organisational action is needed to provide management support for staff.

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Section: Discussionmentioning

confidence: 99%

Staff experiences working in community‐based services for people with learning disabilities who show behaviour described as challenging: The role of management support

Deveau

McGill

2019

Brit J Learn Disabil

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“…As Scales et al (2017) were observed in relation to handover timings, participants, locations and content -and these all have implications for resident safety. It might be expected this would be the case given the variability of residents' dependency levels and the aim of offering personalised care and the key role of a manager in shaping care home culture (Orellana et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

What makes a good handover in a care home for older people?

Moriarty

Norrie

Manthorpe

et al. 2019

WWOP

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Working with Older PeopleWhat makes a good handover in a care home for older people?1 What makes a good handover in a care home for older people?The study aimed to investigate the content, purpose and effectiveness of the handover of information between care home staff beginning and completing a shift. Design/methodology/approachThis was an exploratory study drawing on ethnographic methods. A total of 27 interviews with a range of care home staff, including managers, registered nurses, senior care workers and care workers were undertaken in five care homes selected to give a good contrast in terms of size, ownership, shift patterns, and type of handover. FindingsMost handovers were short -lasting 15 minutes or so -and were held in the office or secluded area in which staff could talk privately. They lasted longer in one home in which the incoming and outgoing shift physically visited each resident's room and the communal spaces. Staff felt that handovers were important for the efficient running of the home as well as to alert everyone to changes in a resident's health or important events, such as a hospital appointment. In one home, hand-held devices enabled staff to follow a resident's care plan and update what was happening in real time. Research limitations/implicationsThis was a small scale study based on data from a limited number of care homes.The increasing popularity of 12 hour shifts means that many homes only hold two short handovers early in the morning and in the evening when the night staff arrive. There appears to be a trend to reduce the number of staff paid to attend handover. Despite this, handovers remain an important component of the routine of a care home. The information contained in handover relates to the running of the care home, as well as residents'wellbeing, suggesting that, while their content overlaps with written records in the home, they are not superfluous. Originality/valueAlthough the literature on handovers in hospitals is extensive, this appears to be the first published study of handover practices in care homes.

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“…Owing to the few papers identified, unlike Burra et al 61 and Ennis et al 62 we did not adopt a critical appraisal approach to rating the quality of studies, thereby following procedures generally categorised as scoping reviews. 63 One key reason for this is that such an approach risks overlooking studies with small sample sizes and, thus, might exclude individual case study or whole-hostel research if the numbers of older residents were not sizeable. Ennis et al 62 considered a sample size of over 100 to be 'good', but, as discussed below, we found few studies reporting such numbers.…”

Section: Process Of the Reviewmentioning

confidence: 99%

Service provision for older homeless people with memory problems: a mixed-methods study

Manthorpe

Samsi

Joly

et al. 2019

Health Serv Deliv Res

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Background Early or timely recognition of dementia is a key policy goal of the National Dementia Strategy. However, older people who are homeless are not considered in this policy and practice imperative, despite their high risk of developing dementia. Objectives and study design This 24-month study was designed to (1) determine the prevalence of memory problems among hostel-dwelling homeless older people and the extent to which staff are aware of these problems; (2) identify help and support received, current care and support pathways; (3) explore quality of life among older homeless people with memory problems; (4) investigate service costs for older homeless people with memory problems, compared with services costs for those without; and (5) identify unmet needs or gaps in services. Participants Following two literature reviews to help study development, we recruited eight hostels – four in London and four in North England. From these, we first interviewed 62 older homeless people, exploring current health, lifestyle and memory. Memory assessment was also conducted with these participants. Of these participants, 47 were included in the case study groups – 23 had ‘memory problems’, 17 had ‘no memory problems’ and 7 were ‘borderline’. We interviewed 43 hostel staff who were participants’ key workers. We went back 3 and 6 months later to ask further about residents’ support, service costs and any unmet needs. Findings Overall, the general system of memory assessment for this group was found to be difficult to access and not patient-centred. Older people living in hostels are likely to have several long-term conditions including mental health needs, which remain largely unacknowledged. Participants frequently reported experiences of declining abilities and hostel staff were often undertaking substantial care for residents. Limitations The hostels that were accessed were mainly in urban areas, and the needs of homeless people in rural areas were not specifically captured. For many residents, we were unable to access NHS data. Many hostel staff referred to this study as ‘dementia’ focused when introducing it to residents, which may have deterred recruitment. Conclusions To the best of our knowledge, no other study and no policy acknowledges hostels as ‘dementia communities’ or questions the appropriateness of hostel accommodation for people with dementia. Given the declining number of hostels in England, the limits of NHS engagement with this sector and growing homelessness, this group of people with dementia are under-recognised and excluded from other initiatives. Future work A longitudinal study could follow hostel dwellers and outcomes. Ways of improving clinical assessment, record-keeping and treatment could be investigated. A dementia diagnosis could trigger sustained care co-ordination for this vulnerable group. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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What do we know about care home managers? Findings of a scoping review

Cited by 34 publications

References 23 publications

Staff experiences working in community‐based services for people with learning disabilities who show behaviour described as challenging: The role of management support

Staff experiences working in community‐based services for people with learning disabilities who show behaviour described as challenging: The role of management support

What makes a good handover in a care home for older people?

Service provision for older homeless people with memory problems: a mixed-methods study

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